52 articles - From Friday Jun 03 2022 to Friday Jun 10 2022
Guidelines, position statements, white papers, technical reviews, consensus statements, etc…
meta-analyses and systematic reviews
| Clin Kidney J |
Sex differences in chronic kidney disease prevalence in Asia: a systematic review and meta-analysis. Current evidence suggests considerable between-country and -region heterogeneity in the female male PR of CKD. However, there remains a large part of the region where data on sex-specific CKD prevalence are absent or limited. Country-level assessment of the differential burden of CKD in females and males is needed to define locally relevant policies that address the needs of both sexes. |
RCT, clinical trials, retrospective studies, etc…
| Am J Kidney Dis |
A Clinical Response-Adjusted Steroid Treatment Protocol for Children With Newly Diagnosed Idiopathic Nephrotic Syndrome. These findings demonstrate the feasibility of a shortened duration of steroid dosing for INS when patients demonstrate an initial clinical response to treatment. A larger study is needed to characterize the relative efficacy and toxicity of this novel treatment regimen. |
The Risk of Cardiovascular Events in Individuals With Primary Glomerular Diseases. Patients with primary glomerular disease have a high absolute risk of CVD that is approximately 2.5 times that of the general population. Consideration of eGFR, proteinuria, and type of glomerular disease may improve risk stratification of CVD in these individuals. |
| Clin J Am Soc Nephrol |
Automated Determination of Left Ventricular Function Using Electrocardiogram Data in Patients on Maintenance Hemodialysis. A deep learning model can determine left ventricular ejection fraction for patients on hemodialysis following pretraining on electrocardiograms of patients not on hemodialysis. Predictions of low ejection fraction from this model were associated with mortality over a 5-year follow-up period. Podcast This article contains a podcast at |
Treatment Decision Making for Older Kidney Patients during COVID-19. Results We interviewed 76 participants (39 patients, 17 care partners, and 20 clinicians). Among patient participants, 13 (33%) patients identified as Black, and seven (18%) had initiated dialysis. Four themes with corresponding subthemes emerged related to treatment decision making and the COVID-19 pandemic: ( Decision Aid for Renal Therapy (DART), NCT03522740. |
| Clin Kidney J |
Association between bone mineral density at different anatomical sites and both mortality and fracture risk in patients receiving renal replacement therapy: a longitudinal study. BMD measured at the femoral neck is predictive of mortality in patients requiring RRT, regardless of modality. Low BMD might be a marker of global patient frailty rather than a direct causal factor in this setting. FNBMD is also a strong predictor of hip and any fracture risk in this population, regardless of bone turnover as assessed by PTH levels. FNBMD is thus an overall prognostic marker in patients requiring RRT. |
Association of urinary albumin:creatinine ratio with incident frailty in older populations. Albuminuria was positively associated with the risk of incident frailty, particularly in those with higher hs-CRP, emphasizing the importance of managing both albuminuria and inflammation for primary prevention of frailty. |
Cancer among kidney transplant recipients >20 years after transplantation: post-transplant lymphoproliferative disorder remains the most common cancer type in the ultra long-term. In long-term KTRs, cancer is a leading cause of death. PTLD remains the most common cancer type followed by RCC. These results emphasize the need for focused long-term cancer surveillance protocols. |
Efficacy and safety of warfarin in patients with non-valvular atrial fibrillation and CKD G3-G5D. Warfarin treatment is associated with a lower risk of ischaemic stroke for patients with NVAF and G3, G4 and G5D at the cost of a higher risk of major bleeding for G4-G5D. Existing observational data are conflicting, stressing the need for RCTs on warfarin compared with no treatment in G4-G5D. Awaiting RCTs, it seems reasonable to treat selected patients on dialysis and NVAF with warfarin. |
Ketogenic dietary interventions in autosomal dominant polycystic kidney disease-a retrospective case series study: first insights into feasibility, safety and effects. Our preliminary data indicate that KDIs may be safe, feasible and potentially beneficial for ADPKD patients, highlighting that prospective clinical trials are warranted to confirm these results in a controlled setting and elucidate the impact of KDIs specifically on kidney function and cyst progression. |
More dissimilarities than affinities between DNAJB11-PKD and ADPKD. Overall, clinical features of DNAJB11-PKD were more subtle compared with those of ADPKD. DNAJB11-PKD shows a unique renal and extrarenal phenotype, clinical presentation and natural history. Therefore our data support that this genetic disease is classified separately from ADPKD. |
New-onset anemia and associated risk of ESKD and death in non-dialysis CKD patients: a multicohort observational study. New-onset anemia is frequent, particularly in patients with more severe renal damage and in those with diabetes mellitus. The occurrence of anemia, even of a mild degree, is associated with mortality risk and faster progression towards ESKD. |
Postoperative outcomes of cancer surgery in patients with and without kidney failure with dialysis therapy: a matched-pair cohort study. Patients with KFDT had higher rates of postoperative complications and 30-day mortality; however, RDs varied between cancer types. The higher rates of postoperative complications in patients with KFDT were mainly attributable to cardiovascular complications. |
Stopping versus continuing renin-angiotensin-system inhibitors after acute kidney injury and adverse clinical outcomes: an observational study from routine care data. Stopping RASi use among survivors of moderate-to-severe AKI was associated with a similar risk of recurrent AKI, but higher risk of the composite of death, MI and stroke. |
The mysterious death of the beer drinking champ: potential role for hyperacute water loading and acute hyponatremia. 'From a heart attack. Man dies after drinking six litres of beer in a contest' ran the news. We now review the physiology underlying hyperacute water intoxication and discuss the potential contribution of hyperacute water loading and acute hyponatremia to the demise of this patient. |
Timing of the pre-transplant workup for renal transplantation: is there room for improvement? The transplant workup was often started too late and the time needed to complete it was surprisingly long. By starting the transplant workup in a timely fashion and reducing the time spent on the screening examinations, we should be able to register patients on the waiting list before or at least at the start of dialysis. We believe that such an internal audit could be of value for every transplant centre. |
| J Am Soc Nephrol |
Immunological Interaction of HLA-DPB1 and Proteinase 3 in ANCA Vasculitis is Associated with Clinical Disease Activity. presented by HLA DPB1*04:01. While larger studied should validate these findings,, the pathobiology may explain the observed increased risk of relapse in our cohort. Moreover, lack of HLA and autoantigen interaction observed during long-term remission signals immunological non-responsiveness. |
Sources of Variation in the Carbon Footprint of Hemodialysis Treatment. Similar medical treatments provided in a single geographic region by facilities that are part of the same organization may be expected to have small variations in the determinants of greenhouse gas emissions. However, we found substantial variation in carbon footprints across facilities, treatments, and emission contributors. Understanding the magnitude and variation in greenhouse gas emissions may help identify measures to reduce the environmental impact of hemodialysis treatment. |
| Kidney Int |
Blood pressure adaptation in vertebrates: Comparative biology. In an age of overeating and insufficient exercise, modern man does not fully utilize the high levels of physical functions acquired through evolution. Drastic changes in our living environment cause hypertension, the pathogenesis of which remains unknown. To survive in new environments, as might be expected in outer space or underwater, an understanding is required of how changes in blood pressure have occurred that enabled adaptation through evolution in vertebrates. |
Caloric restriction reduces the pro-inflammatory eicosanoid 20- hydroxyeicosatetraenoic acid to protect from acute kidney injury. Interestingly, this effect was accompanied by a partial reversal of caloric restriction-induced changes in protein but not RNA expression pointing towards inflammation, endoplasmic reticulum stress and lipid metabolism. Thus, our findings provide an insight into the mechanisms underlying kidney protection by caloric restriction. Hence, understanding the mediators of preconditioning is an important pre-requisite for moving towards translation to the clinical setting. |
| Nephrol Dial Transplant |
Availability of assisted peritoneal dialysis in Europe: call for increased and equal access. and call to action Many people with advanced kidney disease would prefer to have their dialysis at home, yet if the frail patient chooses PD most healthcare systems cannot provide their choice. AsPD should be available in al countries in Europe and for al renal centres. The top priorities to make this happen are education of renal healthcare teams about the advantages of PD, education of and discussion with patients and their families as they approach the need for dialysis, and engagement with policy makers and healthcare providers to develop and support assistance for PD. |
Evolution of humoral lesions on follow-up biopsy stratifies the risk for renal graft loss after antibody-mediated rejection treatment. Hazard ratio for graft loss in multivariate analysis was 3.91 (p = 0.04), and 5.15 (p = 0.02) for patients with persistence and progression of lesions respectively. The non-invasive parameters classically used to follow the intensity of humoral alloimmune response (evolution of iDSA MFI) and the decline of renal graft function (eGFR loss and persistent proteinuria) showed little clinical value to predict the histological response to AMR therapy. We conclude that an invasive monitoring of the evolution of humoral lesions by the mean of follow-up biopsy performed 3 to 6 months after the initiation of therapy is an interesting tool to predict long term outcome after AMR treatment. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Clin Kidney J |
An update of proliferative glomerulonephritis with monoclonal immunoglobulin deposits. Due to the low detection rate of circulating clones in most patients, confirmation of the disease needs to be combined with renal pathology, which emphasizes the importance of completing light and heavy chain subtype staining. Treatment options for patients with PGNMID differ by etiology. For MGRS-associated PGNMID, the current treatment is primarily empirical and more research evidence is needed to fill the treatment gap. |
Can ketogenic dietary interventions slow disease progression in ADPKD: what we know and what we don't. Whether these benefits are translatable to humans remains unknown. In this issue of report results of a self-enrolled survey of autosomal dominant polycystic kidney disease (ADPKD) patients who have self-administered a ketogenic diet [1]. These results provide interesting insights into the tolerability, potential benefits and harms of such an intervention that could inform a future clinical trial. |
Management of acute renal replacement therapy in critically ill cirrhotic patients. Furthermore, volume management is one of the most complex issues in this cohort, where tools used for ambulatory dialysis have not yet been successfully reproducible in the ICU setting. This review attempts to shed light on the management of acute RRT in the critically ill cirrhotic population based on the current evidence and the newly available tools. We will discuss the timing of RRT initiation and cessation, the modality, anticoagulation and fluid management, as well as the outcomes of the RRT in this population, and provide a brief review of the albumin extracorporeal dialysis from the point of view of a nephrologist. |
Stability and compatibility of antibiotics in peritoneal dialysis solutions. Intraperitoneal (IP) administration of antibiotics is a preferred treatment of peritoneal dialysis (PD)-related peritonitis. Given the treatment duration of up to 2-3 weeks, it is important that robust data on antibiotic stability and compatibility are available to achieve notable treatment success. This article provides a comprehensive review of recent stability and compatibility studies pertaining to a wide range of antibiotics admixed in various PD solutions. |
Stopping kidney protection in the elderly following acute kidney injury: think mortality. Stopping RAS blockade was associated with an increased risk of a primary composite outcome of death, myocardial infarction and stroke, of which a large majority (80%) of events were deaths. In contrast, the risk of hyperkalaemia was reduced and the risk of repeated AKI, CKD progression or heart failure hospitalization was unchanged in patients who stopped RAS blockers. These findings call for a re-evaluation of the practice of stopping RAS blockers in the long-term following AKI and suggest that studies are needed regarding similar practices for SGLT2 inhibitors. |
Trimming the fat: is there a health economic case for the use of new lipid-lowering drugs in chronic kidney disease? A scoping review. This review found PCSK9is were moderately cost-effective in populations with high cardiovascular risk. People with CKD were included as an undifferentiated subpopulation in the primary studies, but application of these findings to CKD-specific populations should be interpreted with caution. There is insufficient evidence for a health economic case to support novel lipid-lowering therapies for advanced CKD. |
| Kidney Int |
Molecular Mechanisms and Therapeutic Targets for Diabetic Kidney Disease. Diabetic kidney disease is initiated by diabetes-related disturbances in glucose metabolism, which then trigger other metabolic, hemodynamic, inflammatory, and fibrotic processes that contribute to disease progression. This review summarizes existing evidence on the molecular drivers of diabetic kidney disease onset and progression, focusing on inflammatory and fibrotic mediators-factors that are largely unaddressed as primary treatment targets and for which there is increasing evidence supporting key roles in the pathophysiology of diabetic kidney disease. Results from recent clinical trials highlight promising new drug therapies, as well as a role for dietary strategies, in treating diabetic kidney disease. |
| Nat Rev Nephrol |
Patient-centred clinical trial design. This limitation can undermine the relevance, reliability and value of trial-based evidence for decision-making in clinical practice and health policy. However, efforts to involve patients with kidney disease are increasing across al stages of the trial process from priority setting, to study design (including selection of outcomes and approaches to improve participant recruitment and retention) and dissemination and implementation of the findings. Harnessing the patient voice in designing trials can ensure that efforts and resources are directed towards patient-centred trials that address the needs, concerns and priorities of patients living with kidney disease with the aim of achieving transformative improvements in care and outcomes. |
Letters to the editors and authors’ replies
| Clin Kidney J |
all remaining publications eg case reports, images of the month, etc…
| Clin J Am Soc Nephrol |
| J Am Soc Nephrol |
| Kidney Int |
| Nat Rev Nephrol |